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Pretransplantation α-fetoprotein level as a predictor of hepatocellular carcinoma recurrence after adult living donor liver transplantation within milan criteria in egyptian patients

The Egyptian Journal of Internal Medicine volume 31, pages 203–207 (2019)Cite this article

Abstract

Background and aim of the work

Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world and the third most common cause of mortality in patients with cancer. HCC represents one of cirrhosis complications. The aim of this study was to assess pretransplantation α-fetoprotein (AFP) level as a predictor for HCC recurrence after living donor liver transplantation (LDLT).

Patients and methods

This is a cross-sectional retrospective study for patients with HCC who underwent LDLT and within Milan criteria. Preoperative assessment was performed to assess etiology, operability, and AFP. Locoregional therapy was performed preoperatively as a bridge therapy or for downstaging in patients beyond the Milan criteria. Postoperative abdominal ultrasound and AFP measurement have been performed for HCC recurrence surveillance, as routine investigations. If there is a suspicious lesion of HCC recurrence, triphasic computed tomographic scan is performed and biopsy may be performed.

Results

Data of 75 patients with HCC who underwent LDLT were analyzed retrospectively. Seventy-three patients were infected with hepatitis C virus; two of them were previously infected with hepatitis B virus, one patient with hepatitis B virus infection, and one patient had hepatitis C virus/hepatitis B virus coinfection. AFP may predict HCC recurrence after LDLT (area under the curve=0.806) at cutoff value of more than 66 ng/ml, with 60% sensitivity, 94.3% specificity, 42.9% positive predictive value, and 97.1% negative predictive value.

Conclusion

Preoperative serum AFP level may predict post-transplant HCC recurrence. It may be used in combination with other factors to create a prognostic model that may predict HCC recurrence after liver transplantation.

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Authors and Affiliations

  1. Department of Internal Medicine, Ain Shams University, Cairo, Egypt

    Magdy Galal, Wesam A. Ibrahim, Ahmed I. Elshafie MD & Christine R. Sedrak

  2. Department of General Surgery, Gastroenterology and Hepatology Unit, Ain Shams University, Cairo, Egypt

    Mohamed Bahaa

Authors
  1. Magdy Galal
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  2. Mohamed Bahaa
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  3. Wesam A. Ibrahim
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  4. Ahmed I. Elshafie MD
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  5. Christine R. Sedrak
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Corresponding author

Correspondence to Ahmed I. Elshafie MD.

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Galal, M., Bahaa, M., Ibrahim, W.A. et al. Pretransplantation α-fetoprotein level as a predictor of hepatocellular carcinoma recurrence after adult living donor liver transplantation within milan criteria in egyptian patients. Egypt J Intern Med 31, 203–207 (2019). https://doi.org/10.4103/ejim.ejim_106_18

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  • DOI: https://doi.org/10.4103/ejim.ejim_106_18

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